Episodit

  • LGBTQIA+ Health Care, Community Disparities and Closing the Knowledge Gap

    LGBTQIA+ Health Care, Community Disparities and Closing the Knowledge Gap

    · The MCG Pediatric Podcast

    There has long since been a knowledge gap in medical education regarding care of LGBTQIA+ patients. This has manifested itself in health disparities that detrimentally affect the LGBTQIA+ population. This podcast serves as a way to start bridging the gap on order to mitigate the effects of bias, discrimination, and prejudice that queer patients often face in health care. Research has shown that consistent, early exposure in medical education to patients from the queer community has been beneficial in preparing future practitioners for gender inclusive care. We must also do our parts as pediatricians to make sure our queer youth grow into confident, thriving queer adults.

    Join Dr. Farrah-Amoy Fullerton, a recent graduate of the pediatric residency program at MCG, and Professor of Pediatrics, Dr. Lisa Leggio, as they introduce LGBTQIA+ health care disparities and describe ways to bridge the gap for eager general practitioners who would like to know more.

    CME Credit (requires free sign up): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19523

    References:

    Bonvicini, K. A. (2017). LGBT healthcare disparities: What progress have we made? Patient Education and Counseling, 100(12), 2357–2361. https://doi.org/10.1016/j.pec.2017.06.003Fish, J. N. (2020). Future directions in understanding and addressing mental health among LGBTQ youth. Journal of Clinical Child & Adolescent Psychology, 49(6), 943–956. https://doi.org/10.1080/15374416.2020.1815207Nowaskie, D. Z., & Patel, A. U. (2020). How much is needed? patient exposure and curricular education on medical students’ LGBT cultural competency. BMC Medical Education, 20(1). https://doi.org/10.1186/s12909-020-02381-1Ormiston, C. K., & Williams, F. (2021). LGBTQ youth mental health during COVID-19: Unmet needs in public health and policy. The Lancet, 399(10324), 501–503. https://doi.org/10.1016/s0140-6736(21)02872-5Reisman, T., & Goldstein, Z. (2018). Case report: Induced lactation in a transgender woman. Transgender Health, 3(1), 24–26. https://doi.org/10.1089/trgh.2017.0044Reisner, S. L., Bradford, J., Hopwood, R., Gonzalez, A., Makadon, H., Todisco, D., Cavanaugh, T., VanDerwarker, R., Grasso, C., Zaslow, S., Boswell, S. L., & Mayer, K. (2015). Comprehensive Transgender Healthcare: The gender affirming clinical and public health model of Fenway Health. Journal of Urban Health, 92(3), 584–592. https://doi.org/10.1007/s11524-015-9947-2Underman, K., Giffort, D., Hyderi, A., & Hirshfield, L. E. (2016). Transgender Health: A standardized patient case for advanced clerkship students. MedEdPORTAL. https://doi.org/10.15766/mep_2374-8265.10518Wamboldt, R., Shuster, S., & Sidhu, B. S. (2021). Lactation induction in a transgender woman wanting to breastfeed: Case report. The Journal of Clinical Endocrinology & Metabolism, 106(5). https://doi.org/10.1210/clinem/dgaa976Wylie, K., Knudson, G., Khan, S. I., Bonierbale, M., Watanyusakul, S., & Baral, S. (2016). Serving transgender people: Clinical Care Considerations and Service Delivery Models in transgender health. The Lancet, 388(10042), 401–411. https://doi.org/10.1016/s0140-6736(16)00682-6The Williams Institute at UCLA School of Law. (2023, July 10). How many adults and youth identify as transgender in the United States? - Williams Institute. Williams Institute. https://williamsinstitute.law.ucla.edu/publications/trans-adults-united-states/https://implicit.harvard.edu/implicit/takeatest.htmlColeman E, Radix AE, Bouman WP, et al. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. Int J Transgend Health. 2022;23(Suppl 1):S1-S259. Published 2022 Sep 6. doi:10.1080/26895269.2022.2100644https://pflag.org/thetrevorproject.org
  • Cyberbullying

    Cyberbullying

    · The MCG Pediatric Podcast

    With the rise of social media, there has also been a rise in cyberbullying. Dr. Ruth Osondu, a child and adolescent psychiatry fellow joins Dr. Dale Peeples a child and adolescent psychiatrist and medical student Bailey Allen to discuss what pediatricians, parents, and teens should know about cyberbullying and suicide risks. Specifically, they will:

    Educate the listener and general community on signs a child/teenager at risk for suicide.Understand the effect of cyberbullying on the mental health of the child and adolescent population.Recognize signs that an adolescent is being cyberbullied.Understand potential preventative measures for cyberbullying.Recognize ways for a child or adolescent to get help if they are being bullied.Recognize the role of the parent of victims of cyberbullying

    CME Credit (requires free sign up): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19521

    References:

    Bauman S. Cyberbullying: What Does Research Tell Us? Theory Into Practice, Emerging Issues in School Bullying Research. 2013;52(4): 249-256. DOI: 10.1080/00405841.2013.829727

    Chan T, Cheun C, Lee Z. Cyberbullying on Social Networking Sites: A Literature Review and and Future Research Directions. Information and Management. 2021;58(2):103411. https://doi.org/10.1016/j.im.202.103411.

    Earls M, Foy J, Green C. “Mental Health Tools for Pediatrics”, Addressing Mental Health Concerns in Pediatrics: A Practical Resource Toolkit for Clinicians. American Academy of Pediatrics. February 2021. https://doi.org/10.1542/9781610024624-2e_s2_02_MH_tools_for_pediatrics

    Englander E, Donnerstein E, Kowalski R, Lin CA, Parti K. Defining Cyberbullying. Pediatrics. 2017 Nov;140(Suppl 2):S148-S151. doi: 10.1542/peds.2016-1758U. PMID: 29093051.

    Englander E. Back to the Drawing Board With Cyberbullying. JAMA Pediatr. 2019 Jun 1;173(6):513-514. doi: 10.1001/jamapediatrics.2019.0690. PMID: 31009032.

    Hamm MP, Newton AS, Chisholm A, Shulhan J, Milne A, Sundar P, Ennis H, Scott SD, Hartling L. Prevalence and Effect of Cyberbullying on Children and Young People: A Scoping Review of Social Media Studies. JAMA Pediatr. 2015 Aug;169(8):770-7. doi: 10.1001/jamapediatrics.2015.0944. PMID: 26098362.

    John A, Glendenning AC, Marchant A, Montgomery P, Stewart A, Wood S, Lloyd K, Hawton K. Self-Harm, Suicidal Behaviours, and Cyberbullying in Children and Young People: Systematic Review. J Med Internet Res. 2018 Apr 19;20(4):e129. doi: 10.2196/jmir.9044. PMID: 29674305; PMCID: PMC5934539.

    Timmons-Mitchell J, Flannery D; What Pediatricians Should Know and Do about Cyberbullying. Pediatr Rev. July 2020; 41 (7): 373–375. https://doi.org/10.1542/pir.2019-0165

    Tozzo P, Cuman O, Moratto E, Caenazzo L. Family and Educational Strategies for Cyberbullying Prevention: A Systematic Review. Int J Environ Res Public Health. 2022 Aug 22;19(16):10452. doi: 10.3390/ijerph191610452. PMID: 36012084; PMCID: PMC9408628.

    John A, Glendenning AC, Marchant A, Montgomery P, Stewart A, Wood S, Lloyd K, Hawton K. Self-Harm, Suicidal Behaviours, and Cyberbullying in Children and Young People: Systematic Review. J Med Internet Res. 2018 Apr 19;20(4):e129. doi: 10.2196/jmir.9044. PMID: 29674305; PMCID: PMC5934539.

    Walrave, Michel, and Wannes Heirman. "Cyberbullying: Predicting victimisation and perpetration." Children & Society 25.1 (2011): 59-72.

  • Puuttuva jakso?

    Paina tästä ja päivitä feedi.

  • Tumor Lysis Syndrome

    Tumor Lysis Syndrome

    · The MCG Pediatric Podcast

    Did you know that the treatments used to cure pediatric cancers can potentially cause a life-threatening event known as tumor lysis syndrome (TLS)? Arfa Ul-Haque and Yazmin Reategui, two third-year medical students, are joined by Pediatric intensivist, Dr. Smitha Mathew, to discuss the evaluation and management for TLS so that it is promptly recognized and treated in the inpatient hospital setting.

    Specifically, they will:

    Review the basic assessment skills and evaluation for a child presenting with potential TLS Discuss the influence of chemotherapy, initial presentation, diagnostic options, and management of electrolyte imbalances found in TLS Medications reviewed: daunorubicin, cytarabine, calcium gluconate, Rasburicase, allopurinol Anticipatory guidance to medical professionals for potential onset of TLS Special thanks to Dr. Eric Ring and Dr. Rebecca Yang for peer reviewing this episode.

    CME Credit (requires free sign up): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19520

    References:

    Tumor lysis syndrome. (2022, October 4). Medscape.com. https://emedicine.medscape.com/article/282171-overviewAdeyinka A, Bashir K. Tumor Lysis Syndrome. [Updated 2022 Oct 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK518985/Cheung WL, Hon KL, Fung CM, Leung AKC. Tumor lysis syndrome in childhood malignancies. Drugs in Context 2020; 9: 2019-8-2. DOI: 10.7573/dic.2019-8-2Cheung, Ho Hung MBBSa; She, Wong Hoi MBBSa,∗; Yap, Desmond Y.H. MDb; Tsang, Simon H.Y. MBChBa; Cheung, Tan To MDc. A case report of tumor lysis syndrome after stage-one ALPPS. Medicine 101(10):p e29040, March 11, 2022. | DOI: 10.1097/MD.0000000000029040Flood, K., Rozmus, J., Skippen, P., Matsell, D. G., & Mammen, C. (2021). Fluid overload and acute kidney injury in children with tumor lysis syndrome. Pediatric Blood & Cancer, 68(12), e29255. https://doi.org/10.1002/pbc.29255Barbar T, Jaffer Sathick I. Tumor Lysis Syndrome. Adv Chronic Kidney Dis. 2021 Sep;28(5):438-446.e1. doi: 10.1053/j.ackd.2021.09.007. PMID: 35190110.Adeyinka A, Bashir K. Tumor Lysis Syndrome. [Updated 2022 Oct 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK518985/Shenoy MT, D'Souza B, Akshatha LN, D'Souza V, Rajan MG. Spontaneous Tumor Lysis Syndrome in an Infant: A Case Report. Indian J Clin Biochem. 2015 Jul;30(3):360-2. doi: 10.1007/s12291-014-0472-y. Epub 2015 Feb 14. PMID: 26089626; PMCID: PMC4469048.Alakel N, Middeke JM, Schetelig J, Bornhäuser M. Prevention and treatment of tumor lysis syndrome, and the efficacy and role of rasburicase. Onco Targets Ther. 2017 Feb 2;10:597-605. doi: 10.2147/OTT.S103864. PMID: 28203093; PMCID: PMC5295804.Kollathodi SB, Parameswaran KK, Madhavan L, Kuruvilla S. Hematological malignancies presenting as spontaneous tumor lysis syndrome: A case series. J Family Med Prim Care. 2018 Sep-Oct;7(5):1116-1119. doi: 10.4103/jfmpc.jfmpc_171_18. PMID: 30598972; PMCID: PMC6259502.
  • Developmental Dysplasia of The Hip

    Developmental Dysplasia of The Hip

    · The MCG Pediatric Podcast

    Did you know that undiagnosed developmental dysplasia of the hip (DDH) is the most common cause of arthritis in women under 40? Dr. Melissa Allen, a Pediatric Orthopedic Surgeon, joins 3rd year Pediatric Resident Erica DeMaagd and 4th year medical student Jacob Weiser to discuss the evaluation and management for DDH. Specifically, they will teach how to:

    Recognize common history and physical exam findings associated with hip dysplasia.Be able to formulate a differential diagnosis for hip dysplasia.Understand the initial diagnostic approach to hip dysplasia.Select appropriate imaging to evaluate for hip dysplasia.Help parents understand initial treatment.Create an appropriate disposition for patients with abnormal hip exams.Recognize when to refer patients with hip dysplasia (condition) to orthopedic surgery (specialists).

    Special thanks to Dr. Lisa Leggio and Dr. Rebecca Yang for peer reviewing this episode.

    CME Credit (requires free sign up): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19519

    References:

    Auriemma, J., & Potisek, N. M. (2018). Developmental dysplasia of the hip. Pediatrics In Review, 39(11), 570–572. https://doi.org/10.1542/pir.2017-0239

    Barrera, C. A., Cohen, S. A., Sankar, W. N., Ho-Fung, V. M., Sze, R. W., & Nguyen, J. C. (2019). Imaging of Developmental Dysplasia of the hip: Ultrasound, Radiography and Magnetic Resonance Imaging. Pediatric Radiology, 49(12), 1652–1668. https://doi.org/10.1007/s00247-019-04504-3

    Centers for Disease Control and Prevention. (2022, December 8). Important Milestones: Your Baby by One Year. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/actearly/milestones/milestones-1yr.html

    Imrie, M., Scott, V., Stearns, P., Bastrom, T., & Mubarak, S. J. (2010). Is Ultrasound Screening for DDH in Babies Born Breech Sufficient? Journal of Children’s Orthopaedics, 4(1), 3–8. Larson, J. E., Patel, A. R., Weatherford, B., & Janicki, J. A. (2019). Timing of Pavlik Harness Initiation: Can We wait? Journal of Pediatric Orthopaedics, 39(7), 335–338. https://doi.org/10.1097/bpo.0000000000000930

    Mahan, S. T., Katz, J. N., & Kim, Y.-J. (2009). To Screen or Not to Screen? A Decision Analysis of the Utility of Screening for Developmental Dysplasia of the Hip. The Journal of Bone and Joint Surgery-American Volume, 91(7), 1705–1719. https://doi.org/10.2106/jbjs.h.00122

    Nemeth, B. A., & Narotam, V. (2012). Developmental Dysplasia of the Hip. Pediatrics in Review, 33(12), 553–561. https://doi.org/10.1542/pir.33-12-553

    Novais, E. (2018). Pavlik Harness. Boston, MA; Boston Children’s Hospital Child and Young Adult Hip Preservation Program.

    Shaw BA, Segal LS, AAP SECTION ON ORTHOPAEDICS. Evaluation and Referral for Developmental Dysplasia of the Hip in Infants. Pediatrics. 2016;138(6):e20163107

    Scott Yang, Natalie Zusman, Elizabeth Lieberman, Rachel Y. Goldstein; Developmental Dysplasia of the Hip. Pediatrics January 2019; 143 (1): e20181147. 10.1542/peds.2018-1147

  • Community Acquired Pneumonia in Children

    Community Acquired Pneumonia in Children

    · The MCG Pediatric Podcast

    Community acquired pneumonia is unfortunately a common condition seen in children of all ages. Dr. Jacob Eichenberger, an associate professor of pediatrics at MCG and a pediatric hospitalist at the Children's Hospital of Georgia, joins recently graduated pediatric resident, Dr. Fahim Thawer, and medical student Sara Attari to discuss the evaluation and management of community acquired pneumonia.

    Specifically, they will:

    • Discuss common history and physical exam findings associated with community acquired pneumonia• Formulate a differential diagnoses• Work through the initial diagnostic approach and treatment • Discuss prognosis and prevention

    CME Link (requires login): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19518

  • Cough in the Pediatric Patient

    Cough in the Pediatric Patient

    · The MCG Pediatric Podcast

    Coughs are one of the most common symptoms of childhood illness. But when should we start to get worried? What is a child’s cough trying to tell you? Dr. Sunil Kapoor, a Pediatric Pulmonology Physician, joins Dr. Rebecca Yang and medical student Aparna Prasad to discuss the evaluation and management of chronic cough in children. Specifically, they will:

    Review the history and physical examination for a child presenting with a chronic coughDiscuss the treatment for the most common causes of cough in childrenEvaluate the symptoms that suggest an underlying immunodeficiencyReview the criteria for a referral to pulmonology

    Special thanks to Dr. Dionne Adair, Dr.Sunil Kapoor, and Dr. Rebecca Yang for peer reviewing this episode.

    CME Credit (requires free sign up): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19516

    References:

    Marchant, J. (2021, September 30). Causes of chronic cough in children. UpToDate. Retrieved June 2, 2022, from https://www.uptodate.com/contents/causes-of-chronic-cough-in-children?search=common+causes+of+chronic+cough+in+young+kids&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1   Chang, A. (2020, November 18). Approach to chronic cough in children. UpToDate. Retrieved June 2, 2022, from https://www.uptodate.com/contents/approach-to-chronic-cough-in-children?search=common+causes+of+chronic+cough+in+young+kids&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2   Gregory, S. (2021, May 4). Asthma in children younger than 12 years: Overview of initiating therapy and monitoring control. UpToDate. Retrieved June 2, 2022, from https://www.uptodate.com/contents/asthma-in-children-younger-than-12-years-overview-of-initiating-therapy-and-monitoring-control?search=chronic+cough+in+children&topicRef=91328&source=related_link   Pratter M. Chronic upper airway cough syndrome secondary to rhinosinus diseases (previously referred to as postnasal drip syndrome): ACCP evidence-based clinical practice guidelines. Chest. 2006;129(1 suppl):63S-71S.
  • Syncope in the Pediatric Patient

    Syncope in the Pediatric Patient

    · The MCG Pediatric Podcast

    Did you know around 15 to 25% of children will have at least one syncopal episode before adulthood? Join medical students Sanya Dudani and Caleb Robertson, along with Pediatric Cardiologist Dr. John Plowden, as they discuss the evaluation and management of syncope in the pediatric patient. Specifically, they will:

    Discuss the definition of syncope and its underlying pathophysiologyRecall the incidence and risk factors of syncope in the pediatric populationDescribe the various etiologies and their distinguishing factorsUnderstand the proper approach to taking a history for a pediatric patient with a chief complaint of syncopeRecognize findings on the physical exam that help narrow the differential diagnosisUnderstand the appropriate lab tests and imaging neededDiscuss when it's appropriate to refer patients to specialists

    Special thanks to Dr. Rebecca Yang and Dr. Melissa Lefebvre for peer reviewing this episode!

    CME Credit (requires free sign up): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19514

    References:

    Arthur W, Kaye GC The pathophysiology of common causes of syncope Postgraduate Medical Journal 2000;76:750-753.

    Cipolla MJ. The Cerebral Circulation. San Rafael (CA): Morgan & Claypool Life Sciences; 2009. Chapter 5, Control of Cerebral Blood Flow. Available from: https://www.ncbi.nlm.nih.gov/books/NBK53082/

    Clark, BC, Hayman, JM, Berul, CI, Burns, KM, and Kaltman, JR. Selective use of the electrocardiogram in pediatric preparticipation athletic examinations among pediatric primary care providers. Ann Noninvasive Electrocardiol. 2017; 22:e12446. https://doi.org/10.1111/anec.12446]

    De, A. and Davidson Ward, S.L. (2014), Syncope at altitude: An enigmatic case. Pediatr Pulmonol., 49: E144-E146. https://doi.org/10.1002/ppul.23062

    Gupta A, Menoch M, Levasseur K, Gonzalez IE. Screening Pediatric Patients in New-Onset Syncope (SPINS) Study. Clinical Pediatrics. 2020;59(2):127-133. doi:10.1177/0009922819885660

    Hainsworth, R. Pathophysiology of syncope. Clin Auton Res 14 (Suppl 1), i18–i24 (2004). https://doi.org/10.1007/s10286-004-1004-2

    Phillip A. Low, Paola Sandroni, Chapter 106 - Postural Tachycardia Syndrome (POTS), Editor(s): David Robertson, Italo Biaggioni, Geoffrey Burnstock, Phillip A. Low, Julian F.R. Paton, Primer on the Autonomic Nervous System (Third Edition), Academic Press, 2012, Pages 517-519, ISBN 9780123865250, https://doi.org/10.1016/B978-0-12-386525-0.00106-2

    Zavala, Rennette MD∗; Metais, Benjamin MD†; Tuckfield, Lynnia BS‡; DelVecchio, Michael MD‡; Aronoff, Stephen MD, MBA‡. Pediatric Syncope: A Systematic Review. Pediatric Emergency Care: September 2020 - Volume 36 - Issue 9 - p 442-445 doi: 10.1097/PEC.0000000000002149

  • Biliary Atresia and Considerations after the Kasai Procedure

    Biliary Atresia and Considerations after the Kasai Procedure

    · The MCG Pediatric Podcast

    Did you know that 80% of children with biliary atresia who undergo a Kasai procedure will still require liver transplant at some point in their life? Dr. Bade, a pediatric gastroenterologist, joins medical students Tucker Oliver and Sarah Chappell to discuss evaluation and management of infants with biliary atresia. Specifically, they will:

    Discuss the presentation and diagnosis of biliary atresiaExplain pathophysiology behind jaundiceDiscuss preoperative and postoperative recommendations for the Kasai procedureReview complications and outcomes of the Kasai procedureShare advice for navigating the diagnosis of biliary atresia with families

    Special thanks to Dr. Rebecca Yang and Dr. Jennifer Tucker for peer reviewing this episode.

    FREE CME Credit (requires free sign-up): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19513

    References:

    1] P. J. Lupo et al., “Population-based birth defects data in the United States, 2010-2014: A focus on gastrointestinal defects.,” Birth Defects Res, vol. 109, no. 18, pp. 1504–1514, Nov. 2017, doi: 10.1002/bdr2.1145.

    [2] J. L. Hartley, M. Davenport, and D. A. Kelly, “Biliary atresia,” The Lancet, vol. 374, no. 9702, pp. 1704–1713, Nov. 2009, doi: 10.1016/S0140-6736(09)60946-6.

    [3] S. S. Sundaram, C. L. Mack, A. G. Feldman, and R. J. Sokol, “Biliary atresia: Indications and timing of liver transplantation and optimization of pretransplant care.,” Liver Transpl, vol. 23, no. 1, pp. 96–109, Jan. 2017, doi: 10.1002/lt.24640.

    [4] D. Volpert, F. White, M. J. Finegold, J. Molleston, M. DeBaun, and D. H. Perlmutter, “Outcome of Early Hepatic Portoenterostomy for Biliary Atresia,” J Pediatr Gastroenterol Nutr, vol. 32, no. 3, pp. 265–269, Mar. 2001, doi: 10.1097/00005176-200103000-00006.

    [5] R. Fawaz et al., “Guideline for the Evaluation of Cholestatic Jaundice in Infants: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition.,” J Pediatr Gastroenterol Nutr, vol. 64, no. 1, pp. 154–168, Jan. 2017, doi: 10.1097/MPG.0000000000001334.

    [6] P. H. Y. Chung et al., “Life long follow up and management strategies of patients living with native livers after Kasai portoenterostomy.,” Sci Rep, vol. 11, no. 1, p. 11207, May 2021, doi: 10.1038/s41598-021-90860-w.

    [7] E. H. Gad, Y. Kamel, T. A.-H. Salem, M. A.-H. Ali, and A. N. Sallam, “Short- and long-term outcomes after Kasai operation for type III biliary atresia: Twenty years of experience in a single tertiary Egyptian center-A retrospective cohort study.,” Ann Med Surg (Lond), vol. 62, pp. 302–314, Feb. 2021, doi: 10.1016/j.amsu.2021.01.052.

    [8] A. M. Calinescu et al., “Cholangitis Definition and Treatment after Kasai Hepatoportoenterostomy for Biliary Atresia: A Delphi Process and International Expert Panel.,” J Clin Med, vol. 11, no. 3, Jan. 2022, doi: 10.3390/jcm11030494.

    [9] S. Kiriyama et al., “Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholangitis (with videos),” J Hepatobiliary Pancreat Sci, vol. 25, no. 1, pp. 17–30, Jan. 2018, doi: 10.1002/jhbp.512.

    [10] K. Decharun, C. M. Leys, K. W. West, and S. M. E. Finnell, “Prophylactic Antibiotics for Prevention of Cholangitis in Patients With Biliary Atresia Status Post-Kasai Portoenterostomy,” Clin Pediatr (Phila), vol. 55, no. 1, pp. 66–72, Jan. 2016, doi: 10.1177/0009922815594760.

    [11] E. Jung, W.-H. Park, and S.-O. Choi, “Late complications and current status of long-term survivals over 10 years after Kasai portoenterostomy.,” J Korean Surg Soc, vol. 81, no. 4, pp. 271–5, Oct. 2011, doi: 10.4174/jkss.2011.81.4.271.

    [12] S. S. Sundaram et al., “Health related quality of life in patients with biliary atresia surviving with their native liver.,” J Pediatr, vol. 163, no. 4, pp. 1052–7.e2, Oct. 2013, doi: 10.1016/j.jpeds.2013.04.037.

    [13] B. L. Shneider et al., “Efficacy of fat-soluble vitamin supplementation in infants with biliary atresia.,” Pediatrics, vol. 130, no. 3, pp. e607-14, Sep. 2012, doi: 10.1542/peds.2011-1423.

    [14] J. P. Molleston and B. L. Shneider, “Preventing variceal bleeding in infants and children: is less more?,” Gastroenterology, vol. 145, no. 4, pp. 719–22, Oct. 2013, doi: 10.1053/j.gastro.2013.08.026.

    [15] G. Grisotti and R. A. Cowles, “Complications in pediatric hepatobiliary surgery,” Semin Pediatr Surg, vol. 25, no. 6, pp. 388–394, Dec. 2016, doi: 10.1053/j.sempedsurg.2016.10.004.

    [16] F. R. Sinatra, “Consultation with the Specialist: Liver Transplantation for Biliary Atresia,” Pediatr Rev, vol. 22, no. 5, pp. 166–168, May 2001, doi: 10.1542/pir.22-5-166.

    [17] I. Sriram and D. Nicklas, “Biliary Atresia,” Pediatr Rev, vol. 43, no. 11, pp. 659–661, Nov. 2022, doi: 10.1542/pir.2021-005287.

    [18] L. H. Rodijk et al., “Parental wellbeing after diagnosing a child with biliary atresia: A prospective cohort study.,” J Pediatr Surg, vol. 57, no. 4, pp. 649–654, Apr. 2022, doi: 10.1016/j.jpedsurg.2021.05.026.

    [19] A. Sanchez-Valle, N. Kassira, V. C. Varela, S. C. Radu, C. Paidas, and R. S. Kirby, “Biliary Atresia: Epidemiology, Genetics, Clinical Update, and Public Health Perspective.,” Adv Pediatr, vol. 64, no. 1, pp. 285–305, Aug. 2017, doi: 10.1016/j.yapd.2017.03.012.

  • Salicylate Toxicity Management in Children

    Salicylate Toxicity Management in Children

    · The MCG Pediatric Podcast

    Did you know that salicylate containing substances alone were responsible for over 6,000 cases of pediatric poison exposures in 2020? Dr. Arden Conway, a Pediatric Critical Care Physician, joins Medical Students Morgan Franklin and Ifrah Waris to discuss the evaluation and management for salicylate overdose in a pediatric patient. Specifically, they will:

    • Review the pathophysiology of salicylate toxicity• Review the basic assessment skills for acutely ill pediatric patients• Discuss the diagnostic options and evaluation for a child presenting with a potential salicylate overdose• Discuss the management and monitoring of salicylate overdose• Medications and treatments reviewed: activated charcoal, elimination enhancement, hemodialysis • Discuss the potential complications of salicylate overdose

    Special thanks to Dr. Rebecca Yang and Dr. Jennifer Tucker for peer reviewing this episode.

    FREE CME Credit (requires free sign-up): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19512

    References:

    Anderson, M. (2021). Initial management of suspected poisoning in children and young people. Paediatrics and Child Health, 31(10), 382-387.

    Chyka PA, Erdman AR, Christianson G, Wax PM, Booze LL, Manoguerra AS, Caravati EM, Nelson LS, Olson KR, Cobaugh DJ, Scharman EJ, Woolf AD, Troutman WG; Americal Association of Poison Control Centers; Healthcare Systems Bureau, Health Resources and Sevices Administration, Department of Health and Human Services. Salicylate poisoning: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2007;45(2):95-131. doi: 10.1080/15563650600907140.

    Darracq, M. A., & Cantrell, F. L. (20136). Hemodialysis and extracorporeal removal after pediatric and adolescent poisoning reported to a state poison center. The Journal of Emergency Medicine., 44(6), 1101–1107. https://doi.org/10.1016/j.jemermed.2012.12.018

    Espírito Santo, R., Vaz, S., Jalles, F., Boto, L., & Abecasis, F. (2017). Salicylate Intoxication in an Infant: A Case Report. Drug safety - case reports, 4(1), 23. https://doi.org/10.1007/s40800-017-0065-9

    Gummin DD, Mowry JB, Beuhler MC, Spyker DA, Bronstein AC, Rivers LJ, Pham NPT, Weber J. 2020 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 38th Annual Report. Clin Toxicol (Phila). 2021 Dec;59(12):1282-1501. doi: 10.1080/15563650.2021.1989785.

    Mukerji V, Alpert MA, Flaker GC, Beach CL, Weber RD. Cardiac conduction abnormalities and atrial arrhythmias associated with salicylate toxicity. Pharmacotherapy. 1986 Jan-Feb;6(1):41-3. doi: 10.1002/j.1875-9114.1986.tb03449.x.

    Palmer, B. F., & Clegg, D. J. (2020). Salicylate toxicity. New England Journal of Medicine, 382(26), 2544-2555.

    Runde TJ, Nappe TM. Salicylates Toxicity. [Updated 2021 Jul 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499879/

  • Catch Up Immunizations for Children

    Catch Up Immunizations for Children

    · The MCG Pediatric Podcast

    Immunizations are a critical component of the well child management in pediatric patients, as they are responsible for the prevention of numerous serious diseases with devastating consequences even if adequately treated. While many providers are well versed in the standard immunization schedule for children, the care and management of under-immunized children may present itself a challenge. Join Dr. Shreeti Kapoor, a general pediatrician for over 25 years, and recent Pediatric Resident graduate, Dr. Monique Bailey as they discuss caring for under-immunized children. Specifically, they will:

    Review the recommended vaccination schedule for all children, with a focus on those aged 0-4 years.Discuss the CDC catch-up immunization schedule with examples from three different age groups.Consider the special case of catch-up vaccination for international adoptees as well as interpreting records containing other immunizations (e.g. BCG vaccine) from a few examples of international endemic areas.Review common causes of febrile illnesses in young, vaccinated and under-immunized children.Examine the treatment algorithm and recommended prophylactic antibiotic options for unvaccinated or under-immunized children.Special thanks to Dr. Leila Stallworth, Dr. Erica Sapp and Dr. Rebecca Yang for peer reviewing this episode.

    FREE CME Credit (requires free sign-up): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19511

    References:

    Centers for Disease Control and Prevention. (2022, February 17). Birth-18 years immunization schedule. Centers for Disease Control and Prevention. Retrieved April 5, 2022, from https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html

    Centers for Disease Control and Prevention. (2022, February 17). Catch-up immunization schedule. Centers for Disease Control and Prevention. Retrieved April 5, 2022, from https://www.cdc.gov/vaccines/schedules/hcp/imz/catchup.html

    Finkel, L. , Ospina-Jimenez, C. , Byers, M. & Eilbert, W. (2021). Fever Without Source in Unvaccinated Children Aged 3 to 24 Months. Pediatric Emergency Care, 37 (12), e882-e885. doi: 10.1097/PEC.0000000000002249.

    Starr M. (2013). Paediatric travel medicine: vaccines and medications. British journal of clinical pharmacology, 75(6), 1422–1432. https://doi.org/10.1111/bcp.12035

    NHS. (2019, April 26). BCG vaccine for tuberculosis (TB) overview. NHS choices. Retrieved April 6, 2022, from https://www.nhs.uk/conditions/vaccinations/bcg-tuberculosis-tb-vaccine/

    Centers for Disease Control and Prevention. (2019, October 30). Typhoid vaccine information statement. Centers for Disease Control and Prevention. Retrieved April 6, 2022, from https://www.cdc.gov/vaccines/hcp/vis/vis-statements/typhoid.html#:~:text=There%20are%20two%20vaccines%20to,as%20an%20injection%20(shot)

    Lopez, A. L., Gonzales, M. L., Aldaba, J. G., & Nair, G. B. (2014). Killed oral cholera vaccines: history, development and implementation challenges. Therapeutic advances in vaccines, 2(5), 123–136. https://doi.org/10.1177/2051013614537819

    Lee DID, Vanderhout S, Aglipay M, Birken CS, Morris SK, Piché-Renaud PP, Keown-Stoneman CDG, Maguire JL. Delay in childhood vaccinations during the COVID-19 pandemic. Can J Public Health. 2022 Feb;113(1):126-134. doi: 10.17269/s41997-021-00601-9

    Kroger A, Bahta L, Hunter P. General best practice guidelines for immunization. Best practices guidance of the Advisory Committee on Immunization Practices (ACIP). Special situations. https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/special-situations.html

  • Pollen-Food Allergy Syndrome (PFAS)

    Pollen-Food Allergy Syndrome (PFAS)

    · The MCG Pediatric Podcast

    Have you ever eaten something and began feeling itchiness and tingling of your lips or throat? This could be due to PFAS, which stands for Pollen-Food Allergy Syndrome. PFAS is a hypersensitivity reaction that can occur in individuals who have seasonal allergic rhinitis. The symptoms are caused by a cross-reactivity between plant pollens and food proteins following the ingestion of certain fresh fruits, vegetables, and nuts. Join medical student Ryan Boykin and Pediatric Allergist Dr. Sarah Spriet as they discuss the evaluation, diagnosis, and management of PFAS.

    After listening to this episode, leaners should be able to:

    Describe the pathophysiology of PFASUnderstand the differences between PFAS and an IgE-mediated food allergy and identify the diagnostic studies that may aid in distinguishing between the twoRecall common foods associated with PFAS and identify their cross-reactivity patternsIdentify which patients are at greater risk of systemic reactions and when to prescribe an epinephrine auto-injectorIdentify when to refer patients to an Allergy & Immunology subspecialist

    Special thanks to Dr. Richard Bickel and Dr. Rebecca Yang for peer review of content of this episode.

    FREE CME Credit (requires free sign-up): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19510

    References:

    Bolhaar ST, et. al. Efficacy of birch-pollen immunotherapy on cross-reactive food allergy confirmed by skin tests and double-blind food challenges. Clin Exp Allergy. 2004 May;34(5):761-9. doi: 10.1111/j.1365-2222.2004.1939.x. PMID: 15144469.Carlson, G., & Coop, C. (2019). Pollen food allergy syndrome (PFAS): a review of current available literature. Annals of Allergy, Asthma & Immunology, 123(4), 359-365.Osterballe M, Hansen TK, Mortz CG, Bindslev-Jensen C. The clinical relevance of sensitization to pollen-related fruits and vegetables in unselected pollen-sensitized adults. Allergy. 2005 Feb;60(2):218-25. doi: 10.1111/j.1398-9995.2005.00674.x. PMID: 15647044.Poncet, P., Sénéchal, H., & Charpin, D. (2020). Update on pollen-food allergy syndrome. Expert Review of Clinical Immunology, 16(6), 561-578.Priyamvada Tatachar, Smita Kumar; Food-induced Anaphylaxis and Oral Allergy Syndrome. Pediatr RevApril 2008; 29 (4): e23–e27. https://doi.org/10.1542/pir.29-4-e23Sicherer SH. Clinical implications of cross-reactive food allergens. J Allergy Clin Immunol. 2001 Dec;108(6):881-90. doi: 10.1067/mai.2001.118515. PMID: 11742262.Sicherer, S. H., Warren, C. M., Dant, C., Gupta, R. S., & Nadeau, K. C. (2020). Food allergy from infancy through adulthood. The Journal of Allergy and Clinical Immunology: In Practice, 8(6), 1854-1864.
  • Nocturnal Enuresis

    Nocturnal Enuresis

    · The MCG Pediatric Podcast

    Nocturnal enuresis is a common problem for pediatric patients that can be quite distressing for children as well as their parents. In this episode join Madeline Snipes, a medical student at the Medical College of Georgia as she discusses nocturnal enuresis with Chief of Pediatric Urology at the Children's Hospital of Georgia, Dr. Bradley Morganstern, and Associate Professor of Pediatrics, Dr. Susan Goldberg, on an overview of nocturnal enuresis. Specifically, they will review:

    • The definition of nocturnal enuresis and its basic epidemiology. • The potential causes of nocturnal enuresis. • The appropriate workup for a pediatric patient with nocturnal enuresis. • When referral to a pediatric urologist is indicated. • The various treatment options for a pediatric patient with nocturnal enuresis. • And finally the potential sequelae that may result from untreated nocturnal enuresis.

    Special thanks to Dr. Jordan Gitlin, pediatric urologist at NYU’s Winthrop Hospital, and Dr. Shreeti Kapoor, general pediatrician and associate professor of pediatric medicine at the Medical College of Georgia at Augusta University.

    FREE CME Credit (requires free sign-up): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19509

    References:

    1. Nevéus T, Fonseca E, Franco I, et al. Management and treatment of nocturnal enuresis—an updated standardization document from the International Children’s Continence Society. Journal of Pediatric Urology. 2020;16(1):10-19. doi:10.1016/j.jpurol.2019.12.020 2. Järvelin MR, Vikeväinen-Tervonen L, Moilanen I, Huttunen NP. Enuresis in seven-year-old children. Acta paediatrica Scandinavica. 1988;77(1):148-153. doi:10.1111/j.1651-2227.1988.tb10614. 3. de Sena Oliveira AC, Athanasio B da S, Mrad FC de C, et al. Attention deficit and hyperactivity disorder and nocturnal enuresis co-occurrence in the pediatric population: a systematic review and meta-analysis. Pediatric Nephrology. 2021;36(11):3547-3559. doi:10.1007/s00467-021-05083-y 4. Forsythe WI, Redmond A. Enuresis and spontaneous cure rate. Study of 1129 enuretis. Arch Dis Child. 1974;49(4):259-263. doi:10.1136/adc.49.4.259 5. von Gontard A, Mauer-Mucke K, Plück J, Berner W, Lehmkuhl G. Clinical behavioral problems in day- and night-wetting children. Pediatr Nephrol. 1999;13(8):662-667. doi:10.1007/s004670050677 6. Robson WL. Clinical practice. Evaluation and management of enuresis. N Engl J Med. 2009;360(14):1429-1436. doi:10.1056/NEJMcp0808009 7. Yeung CK, Sreedhar B, Sihoe JD, Sit FK, Lau J. Differences in characteristics of nocturnal enuresis between children and adolescents: a critical appraisal from a large epidemiological study. BJU Int. 2006;97(5):1069-1073. doi:10.1111/j.1464-410X.2006.06074.x 8. Sá CA, Martins de Souza SA, Villela MCBVA, et al. Psychological Intervention with Parents Improves Treatment Results and Reduces Punishment in Children with Enuresis: A Randomized Clinical Trial. J Urol. 2021;205(2):570-576. doi:10.1097/JU.0000000000001351 9. Jackson EC. Nocturnal enuresis: giving the child a "lift". J Pediatr. 2009;154(5):636-637. doi:10.1016/j.jpeds.2009.01.041 10. Plaire JC, Pope JC 4th, Kropp BP, et al. Management of ectopic ureters: experience with the upper tract approach. J Urol. 1997;158(3 Pt 2):1245-1247. 11. Alnatour IM, Alnashrati T. Nocturnal Enuresis. Middle East Journal of Family Medicine. 2022;20(7):127-131. doi:10.5742/MEWFM.2022.9525106 12. van Summeren JJGT, Holtman GA, van Ommeren SC, Kollen BJ, Dekker JH, Berger MY. Bladder Symptoms in Children With Functional Constipation: A Systematic Review. J Pediatr Gastroenterol Nutr. 2018;67(5):552-560. doi:10.1097/MPG.0000000000002138 13. Brownrigg N, Braga LH, Rickard M, et al. The impact of a bladder training video versus standard urotherapy on quality of life of children with bladder and bowel dysfunction: A randomized controlled trial. J Pediatr Urol. 2017;13(4):374.e1-374.e8. doi:10.1016/j.jpurol.2017.06.005

  • The Early Days of the Newborn Infant

    The Early Days of the Newborn Infant

    · The MCG Pediatric Podcast

    Bringing home and caring for a newborn can be overwhelming for a new caregiver, but proper guidance and education in the newborn nursery can alleviate many worries… and be lifesaving! Dr. Nirupma Sharma, a Pediatric Hospitalist, is joined by fourth year medical student, and future pediatrician, Grace Porter to discuss key educational areas of newborn care essential for pediatricians and caregivers to know upon discharge from the hospital. Specifically, they will:

    Review key environmental safety factors for the newborn including safe sleep practices, smoke avoidance, caregiver awareness, infectious exposures, and car safety.Discuss normal feeding, voiding, stooling, and spitting up patterns for newborns with anticipatory guidelines for caregivers if infants deviate from those patterns.Special thanks to Dr. Alice Little Caldwell and Dr. Rebecca Yang for peer reviewing this episode.

    FREE CME Credit (requires free sign-up): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19508

    References:

    Rachel Y. Moon, Rebecca F. Carlin, Ivan Hand, THE TASK FORCE ON SUDDEN INFANT DEATH SYNDROME AND THE COMMITTEE ON FETUS AND NEWBORN; Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment. Pediatrics July 2022; 150 (1): e2022057990. 10.1542/peds.2022-057990Johanna B. Warren, Carrie A. Phillipi; Care of the Well Newborn. Pediatr Rev January 2012; 33 (1): 4–18. https://doi.org/10.1542/pir.33-1-4American Academy of Pediatrics. (2022, March 16). Shaken baby syndrome: Protect your infant from abusive head trauma. HealthyChildren.org. Retrieved March 7, 2023, from https://www.healthychildren.org/English/safety-prevention/at-home/Pages/Abusive-Head-Trauma-Shaken-Baby-Syndrome.aspxCenters for Disease Control and Prevention. (2022, June 21). Data and statistics for SIDS and SUID. Centers for Disease Control and Prevention. Retrieved March 7, 2023, from https://www.cdc.gov/sids/data.htmDangers of Secondhand Smoke . Pediatric Patient Education 2021; 10.1542/peo_document025American Academy of Pediatrics. (2021, August 5). Baby's first days: Bowel movements & urination. HealthyChildren.org. Retrieved March 7, 2023, from https://www.healthychildren.org/English/ages-stages/baby/Pages/Babys-First-Days-Bowel-Movements-and-Urination.aspxJennifer, K. (2022, May 9). How often, how much, what color: Your newborn poop and pee questions answered. Lurie Children's. Retrieved March 7, 2023, from https://www.luriechildrens.org/en/blog/what-to-know-about-newborn-poop-and-pee/Pediatric Care Advice; Spitting Up (Normal Reflux). Pediatric Patient Education 2022; 10.1542/ppe_schmitt_225Robert H. Pantell, Kenneth B. Roberts, William G. Adams, Benard P. Dreyer, Nathan Kuppermann, Sean T. O’Leary, Kymika Okechukwu, Charles R. Woods, SUBCOMMITTEE ON FEBRILE INFANTS; Clinical Practice Guideline: Evaluation and Management of Well-Appearing Febrile Infants 8 to 60 Days Old. Pediatrics August 2021; 148 (2): e2021052228. 10.1542/peds.2021-052228Natasha, S. K. (2022, June 30). Depression during & after pregnancy: You are not alone. HealthyChildren.org. Retrieved March 7, 2023, from https://healthychildren.org/English/ages-stages/prenatal/delivery-beyond/Pages/understanding-motherhood-and-mood-baby-blues-and-beyond.aspxDennis R. Durbin, Benjamin D. Hoffman, COUNCIL ON INJURY, VIOLENCE, AND POISON PREVENTION, Phyllis F. Agran, Sarah A. Denny, Michael Hirsh, Brian Johnston, Lois K. Lee, Kathy Monroe, Judy Schaechter, Milton Tenenbein, Mark R. Zonfrillo, Kyran Quinlan; Child Passenger Safety. Pediatrics November 2018; 142 (5): e20182460. 10.1542/peds.2018-2460
  • Noninvasive Respiratory Support

    Noninvasive Respiratory Support

    · The MCG Pediatric Podcast

    Noninvasive respiratory support is an important modality utilized in the pediatric critical care setting to treat respiratory failure without the use of an artificial airway. On today's discussion, pediatric critical care fellow, Dr. John-David Bruce joins pediatric hospitalist, Dr. Brynn Ehlers and Dr. Gene Fisher who is a pediatric intensivist that serves as the division chief of Pediatric Critical Care unit at the Children's Hospital of Georgia.

    After listening to this podcast, learners should be able to:

    1. Recognize different types of noninvasive respiratory support2. Have an understanding of basic settings involved in the different modes of noninvasive respiratory support3. Discuss conditions that are most ideal for noninvasive respiratory support 4. Recognize when it is necessary to escalate to a higher mode of respiratory support5. Common complications of noninvasive respiratory support and how do you treat them.

    FREE CME Credit (requires free sign-up): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19507

    References:

    Amin, R, & Arca, MJ. Feasibility of non-invasive neurally adjusted ventilator assist after congenital diaphragmatic hernia repair. Journal of Pediatric Surgery, 2019;54(3):434-438.Coletti, KD, Bagdure, DN, Walker, LK, Remy, KE, & Custer, JW. High-flow nasal cannula utilization in pediatric critical care. Respiratory Care, 2017;62(8):1023-1029.Desai, JP, & Moustarah, F. Pulmonary Compliance. StatPearls Publishing. 2021. https://www.ncbi.nlm.nih.gov/books/NBK538324/Fedor, KL. Noninvasive respiratory support in infants and children. Respiratory Care, 2017;62(6):699-717.Franklin, D, Babl, FE, & Schlapbach, LJ, et al. A randomized trial of high-flow oxygen therapy in infants with bronchiolitis. The New England Journal of Medicine, 2018;378:1121-1131.Intagliata, S, Rizzo, A, & Gossman, WG. Physiology, Lung Dead Space. StatPearls Publishing. 2020. https://www.ncbi.nlm.nih.gov/books/NBK482501/Morrison, WE, Nelson McMillan, KL, & Shaffner, DH. (Eds.). Roger's Handbook of Pediatric Intensive Care (5th ed.). 2017. Wolters Kluwer.Najaf-Zadeh A, & Leclerc F. Noninvasive positive pressure ventilation for acute respiratory failure in children: a concise review. Ann Intensive Care. 2011;1(1):15. doi:10.1186/2110-5820-1-15Oymar, K, & Bardsen, K. Continuous positive airway pressure for bronchiolitis in a general paediatric ward; a feasibility study. BMC Pediatrics. 2014;14:122.Pope, JF, & Birnkrant, DJ. Noninvasive ventilation to facilitate extubation in a pediatric intensive care unit. Journal of Intensive Care Medicine. 2000;15(2):99-103. Storre, JH, Bohm, P, Dreher, M, & Windisch, W. Clinical impact of leak compensation during non-invasive ventilation. Respiratory Medicine. 2009;103(10):1477-1483. Silver AH, Nazif JM. Bronchiolitis. Pediatr Rev. 2019;40(11):568-576. doi:10.1542/pir.2018-0260
  • Acetaminophen Toxicity

    Acetaminophen Toxicity

    · The MCG Pediatric Podcast

    Did you know that household Tylenol is one of the most common causes of both intentional and unintentional toxicity in the pediatric population? Dr. George Hsu, a Pediatric Emergency Physician, joins Dr. Rebecca Yang and Medical Students Morgan Franklin and Ifrah Waris to discuss the evaluation and management for acetaminophen overdose in a pediatric patient. Specifically, they will:

    Review the basic assessment skills and evaluation for a child presenting with a potential acetaminophen overdoseDiscuss the diagnostic options and monitoring of acetaminophen overdoseDiscuss how to use the Rumack-Matthew nomogram in the treatment of acetaminophen overdoseMedications and treatments reviewed: N-acetylcysteine, activated charcoal, and gastric lavageDiscuss the potential complications of acetaminophen overdoseSpecial thanks to Dr. Rebecca Yang and Dr. Arden Conway for peer reviewing this episode.

    Special thanks to Dr. Rebecca Yang and Dr. Arden Conway for peer reviewing the discussion today.

    FREE CME Credit (requires free sign-up): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19506

    References:

    Agrawal S, Khazaeni B. Acetaminophen Toxicity. [Updated 2021 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441917/Heard K. J. (2008). Acetylcysteine for acetaminophen poisoning. The New England journal of medicine, 359(3), 285–292. https://doi.org/10.1056/NEJMct0708278Hinson JA. Mechanism of acetaminophen-induced liver toxicity. In: Kaplowitz N, DeLeve LD, eds. Drug-Induced Liver Disease. 3rd ed. London, England: Academic Press; 2013:305-330.Hon KL, Hui WF, Leung AKC. Antidotes for childhood toxidromes. Drugs in Context 2021; 10: 2020-11-4. DOI: 10.7573/dic.2020-11-4Greene SL, Dargan PI, Jones AL. Acute poisoning: understanding 90% of cases in a nutshell. Postgrad Med J. 2005 Apr;81(954):204-16. doi: 10.1136/pgmj.2004.024794. PMID: 15811881; PMCID: PMC1743253.Lee J, Fan NC, Yao TC, Hsia SH, Lee EP, Huang JL, Wu HP. Clinical spectrum of acute poisoning in children admitted to the pediatric emergency department. Pediatr Neonatol. 2019 Feb;60(1):59-67. doi: 10.1016/j.pedneo.2018.04.001. Epub 2018 Apr 19. PMID: 29748113.Manov I, Motanis H, Frumin I, Iancu TC. Hepatotoxicity of anti-inflammatory and analgesic drugs: ultrastructural aspects. Acta Pharmacol Sin. 2006 Mar;27(3):259-72. doi: 10.1111/j.1745-7254.2006.00278.x. PMID: 16490160.Myers WC, Otto TA, Harris E, Diaco D, Moreno A. Acetaminophen overdose as a suicidal gesture: a survey of adolescents' knowledge of its potential for toxicity. J Am Acad Child Adolesc Psychiatry. 1992 Jul;31(4):686-90. doi: 10.1097/00004583-199207000-00016. PMID: 1644732.Park, B. K., Dear, J. W., & Antoine, D. J. (2015). Paracetamol (acetaminophen) poisoning. BMJ clinical evidence, 2015, 2101.Riordan M, Rylance G, Berry K. Poisoning in children 2: painkillers. Arch Dis Child. 2002 Nov;87(5):397-9. doi: 10.1136/adc.87.5.397. PMID: 12390909; PMCID: PMC1763068.Silberman J, Galuska MA, Taylor A. Activated Charcoal. [Updated 2022 Jul 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482294/Shekunov, J., Lewis, C. P., Vande Voort, J. L., Bostwick, J. M., & Romanowicz, M. (2021). Clinical Characteristics, Outcomes, Disposition, and Acute Care of Children and Adolescents Treated for Acetaminophen Toxicity. Psychiatric Services, appi-ps.Sheridan DC, Hendrickson RG, Lin AL, Fu R, Horowitz BZ. Adolescent Suicidal Ingestion: National Trends Over a Decade. J Adolesc Health. 2017 Feb;60(2):191-195. doi: 10.1016/j.jadohealth.2016.09.012. Epub 2016 Nov 23. PMID: 27889404.Silberman J, Galuska MA, Taylor A. Activated Charcoal. [Updated 2021 Jul 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482294/Runde TJ, Nappe TM. Salicylates Toxicity. [Updated 2021 Jul 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499879/Yarema M, Chopra P, Sivilotti MLA, Johnson D, Nettel-Aguirre A, Bailey B, Victorino C, Gosselin S, Purssell R, Thompson M, Spyker D, Rumack B. Anaphylactoid Reactions to Intravenous N-Acetylcysteine during Treatment for Acetaminophen Poisoning. J Med Toxicol. 2018 Jun;14(2):120-127. doi: 10.1007/s13181-018-0653-9. Epub 2018 Feb 8. Erratum in: J Med Toxicol. 2018 Mar 12;: PMID: 29423816; PMCID: PMC5962465.
  • Preventing Obesity Through Early Nutrition & Physical Activity

    Preventing Obesity Through Early Nutrition & Physical Activity

    · The MCG Pediatric Podcast

    Over the past two decades the number of children with obesity has continued to rise. Obesity in childhood predisposes children to both immediate and future health risk. Dr. Rebecca Yang, a general pediatrician, joins community pediatrician Dr. Ashley Miller to discuss nutrition and physical activity recommendations throughout childhood. Specifically, they will:

    Discuss the role nutrition and physical activity plays in pediatric obesityEducate on nutritional requirements for healthy growth and developmentDetermine on how food insecurity plays a role in obesityInform about recommendations for physical activity and age-appropriate guidelinesUnderstand the barriers to physical activity

    Special thanks to Dr. Shreeti Kapoor who peer reviewed today’s episode.

    FREE CME Credit (requires free sign-up): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=12494

    References:

    • American Academy of Pediatrics. (2022, May 13). Recommended Drinks for Children Age 5 & Younger. Retrieved from Healthy Children: https://www.healthychildren.org/English/healthy-living/nutrition/Pages/Recommended-Drinks-for-Young-Children-Ages-0-5.aspx• COUNCIL ON COMMUNITY PEDIATRICS, C. O. (2015). Promoting Food Security for All Children. Pediatrics , 136(5), e1431-e1438. doi:10.1542/peds.2015-3301• Felipe Lobelo, Natalie D. Muth, Sara Hanson, Blaise A. Nemeth, COUNCIL ON SPORTS MEDICINE AND FITNESS, SECTION ON OBESITY, Cynthia R. LaBella, M. Alison Brooks, Greg Canty, Alex B. Diamond, William Hennrikus, Kelsey Logan, Kody Moffatt, K. Brooke Pengel, Andrew R. Peterson, Paul R. Stricker, Christopher F. Bolling, Sarah Armstrong, Matthew Allen Haemer, John Rausch, Victoria Rogers, Stephanie Moore Walsh; Physical Activity Assessment and Counseling in Pediatric Clinical Settings. Pediatrics March 2020; 145 (3): e20193992. 10.1542/peds.2019-3992• Hemmingsson E. Early Childhood Obesity Risk Factors: Socioeconomic Adversity, Family Dysfunction, Offspring Distress, and Junk Food Self-Medication. Curr Obes Rep. 2018 Jun;7(2):204-209. doi: 10.1007/s13679-018-0310-2. PMID: 29704182; PMCID: PMC5958160.• Lee JW, Lee M, Lee J, Kim YJ, Ha E, Kim HS. The Protective Effect of Exclusive Breastfeeding on Overweight/Obesity in Children with High Birth Weight. J Korean Med Sci. 2019 Mar 8;34(10):e85. doi: 10.3346/jkms.2019.34.e85. PMID: 30886551; PMCID: PMC6417996.• Maternal Diet. (2022, May 17). Retrieved from Center for Disease Control and Prevention: https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/diet-and-micronutrients/maternal-diet.html• Lobelo F, Muth ND, Hanson S, Nemeth BA; COUNCIL ON SPORTS MEDICINE AND FITNESS; SECTION ON OBESITY. Physical Activity Assessment and Counseling in Pediatric Clinical Settings. Pediatrics. 2020 Mar;145(3):e20193992. doi: 10.1542/peds.2019-3992. Epub 2020 Feb 24. PMID: 32094289.• USDA . (2022, April 22). Definitions of Food Security. Retrieved from USDA Econimic Reserach Service: https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-u-s/definitions-of-food-security/

  • Status Epilepticus

    Status Epilepticus

    · The MCG Pediatric Podcast

    Status Epilepticus is one of the most common pediatric neurologic emergencies and requires prompt, targeted treatment to reduce patient morbidity and mortality. On this podcast, Pediatric Critical Care Physician, Dr. Renuka Mehta, Pediatric Resident Physician, Dr. Yvonne Ibe, and medical student, Emily Austin will discuss management for status epilepticus and rapid interventions that can be potentially lifesaving—because in seizure management, time is brain.

    FREE CME Credit (requires sign-in): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19530

    Thank you for listening to this episode from the Department of Pediatrics at the Medical College of Georgia. An additional thanks to Dr. Lorna Bell, Dr. George Hsu, and Dr. Rebecca Yang who provided editing and peer review of today’s discussion.

    If you have any comments, suggestions, or feedback- you can email us at [email protected]

    Remember that all content during this episode is intended for educational purposes only. It should not be used as medical advice to diagnose or treat any particular patient. Clinical vignette cases presented are based on hypothetical patient scenarios. Thank you for your support!

    References:

    Alldredge, B. K., Gelb, A. M., Isaacs, S. M., Corry, M. D., Allen, F., Ulrich, S., Gottwald, M. D., O’Neil, N., Neuhaus, J. M., Segal, M. R., & Lowenstein, D. H. (2001). A Comparison of Lorazepam, Diazepam, and Placebo for the Treatment of Out-of-Hospital Status Epilepticus. New England Journal of Medicine, 345(9), 631–637. https://doi.org/10.1056/NEJMoa002141

    Chamberlain, J. M., Kapur, J., Shinnar, S., Elm, J., Holsti, M., Babcock, L., Rogers, A., Barsan, W., Cloyd, J., Lowenstein, D., Bleck, T. P., Conwit, R., Meinzer, C., Cock, H., Fountain, N. B., Underwood, E., Connor, J. T., Silbergleit, R., Neurological Emergencies Treatment Trials, & Pediatric Emergency Care Applied Research Network investigators. (2020). Efficacy of levetiracetam, fosphenytoin, and valproate for established status epilepticus by age group (ESETT): a double-blind, responsive-adaptive, randomised controlled trial. Lancet (London, England), 395(10231), 1217–1224. https://doi.org/10.1016/S0140-6736(20)30611-5

    Chamberlain, J. M., Okada, P., Holsti, M., Mahajan, P., Brown, K. M., Vance, C., Gonzalez, V., Lichenstein, R., Stanley, R., Brousseau, D. C., Grubenhoff, J., Zemek, R., Johnson, D. W., Clemons, T. E., & Baren, J. (2014). Lorazepam vs Diazepam for Pediatric Status Epilepticus: A Randomized Clinical Trial. JAMA, 311(16), 1652. https://doi.org/10.1001/jama.2014.2625

    Chen, J., Xie, L., Hu, Y., Lan, X., & Jiang, L. (2018). Nonconvulsive status epilepticus after cessation of convulsive status epilepticus in pediatric intensive care unit patients. Epilepsy & Behavior: E&B, 82, 68–73. https://doi.org/10.1016/j.yebeh.2018.02.008

    Fine, A., & Wirrell, E. C. (2020). Seizures in Children. Pediatrics in Review, 41(7), 321–347. https://doi.org/10.1542/pir.2019-0134

    Glauser, T., Shinnar, S., Gloss, D., Alldredge, B., Arya, R., Bainbridge, J., Bare, M., Bleck, T., Dodson, W. E., Garrity, L., Jagoda, A., Lowenstein, D., Pellock, J., Riviello, J., Sloan, E., & Treiman, D. M. (2016). Evidence-Based Guideline: Treatment of Convulsive Status Epilepticus in Children and Adults: Report of the Guideline Committee of the American Epilepsy Society. Epilepsy Currents, 16(1), 48–61. https://doi.org/10.5698/1535-7597-16.1.48

    Hanhan, U. A., Fiallos, M. R., & Orlowski, J. P. (2001). Status epilepticus. Pediatric Clinics of North America, 48(3), 683–694. https://doi.org/10.1016/s0031-3955(05)70334-5

    Kapur, J., Elm, J., Chamberlain, J. M., Barsan, W., Cloyd, J., Lowenstein, D., Shinnar, S., Conwit, R., Meinzer, C., Cock, H., Fountain, N., Connor, J. T., Silbergleit, R., & NETT and PECARN Investigators. (2019). Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus. The New England Journal of Medicine, 381(22), 2103–2113. https://doi.org/10.1056/NEJMoa1905795

    Lyttle, M. D., Rainford, N. E. A., Gamble, C., Messahel, S., Humphreys, A., Hickey, H., Woolfall, K., Roper, L., Noblet, J., Lee, E. D., Potter, S., Tate, P., Iyer, A., Evans, V., Appleton, R. E., Pereira, M., Hardwick, S., Messahel, S., Noblet, J., … Hobden, G. (2019). Levetiracetam versus phenytoin for second-line treatment of paediatric convulsive status epilepticus (EcLiPSE): a multicentre, open-label, randomised trial. The Lancet, 393(10186), 2125–2134. https://doi.org/10.1016/S0140-6736(19)30724-X

    Raspall‐Chaure, M., Chin, R. F. M., Neville, B. G., Bedford, H., & Scott, R. C. (2007). The Epidemiology of Convulsive Status Epilepticus in Children: A Critical Review. Epilepsia, 48(9), 1652–1663. https://doi.org/https://doi.org/10.1111/j.1528-1167.2007.01175.x

    Riviello, J. J., Ashwal, S., Hirtz, D., Glauser, T., Ballaban-Gil, K., Kelley, K., Morton, L. D., Phillips, S., Sloan, E., Shinnar, S., American Academy of Neurology Subcommittee, & Practice Committee of the Child Neurology Society. (2006). Practice parameter: diagnostic assessment of the child with status epilepticus (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology, 67(9), 1542–1550. https://doi.org/10.1212/01.wnl.0000243197.05519.3d

    Sánchez Fernández, I., Abend, N. S., Agadi, S., An, S., Arya, R., Brenton, J. N., Carpenter, J. L., Chapman, K. E., Gaillard, W. D., Glauser, T. A., Goodkin, H. P., Kapur, K., Mikati, M. A., Peariso, K., Ream, M., Riviello, J., Tasker, R. C., & Loddenkemper, T. (2015). Time from convulsive status epilepticus onset to anticonvulsant administration in children. Neurology, 84(23), 2304–2311. https://doi.org/10.1212/WNL.0000000000001673

    Trinka, E., Cock, H., Hesdorffer, D., Rossetti, A. O., Scheffer, I. E., Shinnar, S., Shorvon, S., & Lowenstein, D. H. (2015). A definition and classification of status epilepticus--Report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia, 56(10), 1515–1523. https://doi.org/10.1111/epi.13121

    Welch, R. D., Nicholas, K., Durkalski-Mauldin, V. L., Lowenstein, D. H., Conwit, R., Mahajan, P. V., Lewandowski, C., Silbergleit, R., & Neurological Emergencies Treatment Trials (NETT) Network Investigators. (2015). Intramuscular midazolam versus intravenous lorazepam for the prehospital treatment of status epilepticus in the pediatric population. Epilepsia, 56(2), 254–262. https://doi.org/10.1111/epi.12905

  • Major Depressive Disorder

    Major Depressive Disorder

    · The MCG Pediatric Podcast

    Amidst the battle of the mental health crisis, major depressive disorder stands out as an all-too-common reality for many children and adolescents, but the forces of science and medicine can stand against this foe. Dr. Christopher Drescher, a clinical child psychologist, joins pediatric resident Dr. Daniel Allen and medical student Vuk Lacmanovic to remove the cape from this increasingly common condition and discuss its symptoms, diagnosis, and treatment. Specifically, they will:

    Define major depressive disorder (MDD) and recognize the common symptoms in both children and adolescents.Formulate a differential diagnosis for patients presenting with depressive symptoms.Recognize validated screening tools for depression in both children and adolescents.Review cognitive behavioral therapy and pharmacotherapy as treatment options.Review appropriate referral to a mental health specialist.

    Free CME Credit (requires sign-in): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=12493

    References:

    Bhatia SK, Bhatia SC. Childhood and adolescent depression. Am Fam Physician. 2007 Jan 1;75(1):73-80. PMID: 17225707.Brent DA, Maalouf F. Depressive Disorders (in Childhood and Adolescence). In: Ebert MH, Leckman JF, Petrakis IL. eds. Current Diagnosis & Treatment: Psychiatry, 3e. McGraw-Hill; Accessed November 17, 2020. https://accessmedicine.mhmedical.com/content.aspx?bookid=2509§ionid=200807606Clark MS, Jansen KL, Cloy JA. Treatment of childhood and adolescent depression. Am Fam Physician. 2012 Sep 1;86(5):442-8. PMID: 22963063.Fendrich M, Weissman MM, Warner V. Screening for depressive disorder in children and adolescents: validating the Center for Epidemiologic Studies Depression Scale for Children. Am J Epidemiol. 1990 Mar;131(3):538-51. doi: 10.1093/oxfordjournals.aje.a115529. PMID: 2301363. (PDF of CES-DC here)Forman-Hoffman V, McClure E, McKeeman J, Wood CT, Middleton JC, Skinner AC, Perrin EM, Viswanathan M. Screening for Major Depressive Disorder in Children and Adolescents: A Systematic Review for the U.S. Preventive Services Task Force. Ann Intern Med. 2016 Mar 1;164(5):342-9. doi: 10.7326/M15-2259. Epub 2016 Feb 9. PMID: 26857836.Hathaway EE, Walkup JT, Strawn JR. Antidepressant Treatment Duration in Pediatric Depressive and Anxiety Disorders: How Long is Long Enough? Curr Probl Pediatr Adolesc Health Care. 2018 Feb;48(2):31-39. doi: 10.1016/j.cppeds.2017.12.002. Epub 2018 Jan 12. PMID: 29337001; PMCID: PMC5828899.March JS, Silva S, Petrycki S, Curry J, Wells K, Fairbank J, Burns B, Domino M, McNulty S, Vitiello B, Severe J. The Treatment for Adolescents With Depression Study (TADS): long-term effectiveness and safety outcomes. Arch Gen Psychiatry. 2007 Oct;64(10):1132-43. doi: 10.1001/archpsyc.64.10.1132. Erratum in: Arch Gen Psychiatry. 2008 Jan;65(1):101. PMID: 17909125.Meister R, Abbas M, Antel J, Peters T, Pan Y, Bingel U, Nestoriuc Y, Hebebrand J. Placebo response rates and potential modifiers in double-blind randomized controlled trials of second and newer generation antidepressants for major depressive disorder in children and adolescents: a systematic review and meta-regression analysis. Eur Child Adolesc Psychiatry. 2020 Mar;29(3):253-273. doi: 10.1007/s00787-018-1244-7. Epub 2018 Dec 8. PMID: 30535589; PMCID: PMC7056684.Rachel A. Zuckerbrot, Amy Cheung, Peter S. Jensen, Ruth E.K. Stein, Danielle Laraque and GLAD-PC STEERING GROUP. Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Part I. Practice Preparation, Identification, Assessment, and Initial Management. Pediatrics March 2018, 141 (3) e20174081; DOI: https://doi.org/10.1542/peds.2017-4081Scott K, Lewis CC, Marti CN. Trajectories of Symptom Change in the Treatment for Adolescents With Depression Study. J Am Acad Child Adolesc Psychiatry. 2019 Mar;58(3):319-328. doi: 10.1016/j.jaac.2018.07.908. Epub 2019 Jan 8. PMID: 30768414; PMCID: PMC6557284.Sharma T, Guski LS, Freund N, Gøtzsche PC. Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports. BMJ. 2016 Jan 27;352:i65. doi: 10.1136/bmj.i65. PMID: 26819231; PMCID: PMC4729837.Siu AL; US Preventive Services Task Force. Screening for Depression in Children and Adolescents: US Preventive Services Task Force Recommendation Statement. Pediatrics. 2016 Mar;137(3):e20154467. doi: 10.1542/peds.2015-4467. Epub 2016 Feb 8. PMID: 26908686.Weersing VR, Brent DA, Rozenman MS, Gonzalez A, Jeffreys M, Dickerson JF, Lynch FL, Porta G, Iyengar S. Brief Behavioral Therapy for Pediatric Anxiety and Depression in Primary Care: A Randomized Clinical Trial. JAMA Psychiatry. 2017 Jun 1;74(6):571-578. doi: 10.1001/jamapsychiatry.2017.0429. PMID: 28423145; PMCID: PMC5539834.Weersing VR, Shamseddeen W, Garber J, Hollon SD, Clarke GN, Beardslee WR, Gladstone TR, Lynch FL, Porta G, Iyengar S, Brent DA. Prevention of Depression in At-Risk Adolescents: Predictors and Moderators of Acute Effects. J Am Acad Child Adolesc Psychiatry. 2016 Mar;55(3):219-26. doi: 10.1016/j.jaac.2015.12.015. Epub 2016 Jan 18. PMID: 26903255; PMCID: PMC4783159.Xu Y, Bai SJ, Lan XH, Qin B, Huang T, Xie P. Randomized controlled trials of serotonin-norepinephrine reuptake inhibitor in treating major depressive disorder in children and adolescents: a meta-analysis of efficacy and acceptability. Braz J Med Biol Res. 2016 May 24;49(6):e4806. doi: 10.1590/1414-431X20164806. PMID: 27240293; PMCID: PMC4897997.Zhou X, Cipriani A, Zhang Y, Cuijpers P, Hetrick SE, Weisz JR, Pu J, Giovane CD, Furukawa TA, Barth J, Coghill D, Leucht S, Yang L, Ravindran AV, Xie P. Comparative efficacy and acceptability of antidepressants, psychological interventions, and their combination for depressive disorder in children and adolescents: protocol for a network meta-analysis. BMJ Open. 2017 Aug 11;7(8):e016608. doi: 10.1136/bmjopen-2017-016608. PMID: 28801423; PMCID: PMC5629731.Zhou X, Teng T, Zhang Y, Del Giovane C, Furukawa TA, Weisz JR, Li X, Cuijpers P, Coghill D, Xiang Y, Hetrick SE, Leucht S, Qin M, Barth J, Ravindran AV, Yang L, Curry J, Fan L, Silva SG, Cipriani A, Xie P. Comparative efficacy and acceptability of antidepressants, psychotherapies, and their combination for acute treatment of children and adolescents with depressive disorder: a systematic review and network meta-analysis. Lancet Psychiatry. 2020 Jul;7(7):581-601. doi: 10.1016/S2215-0366(20)30137-1. PMID: 32563306; PMCID: PMC7303954.
  • Lyme Disease

    Lyme Disease

    · The MCG Pediatric Podcast

    Lyme disease is the most common tick-borne disease in the US that can present in three different stages. Diagnosis is through a combination of a thorough history, review of systems, physical exam, as well as a two-tier serologic testing. Former Pediatric resident, Dr. James Davis, joins Associate Professor of Pediatrics, Dr. Susan Goldberg, to discuss the evaluation and management of Lyme Disease in the pediatric population. After listening to this podcast, learners should be able to:

    Recognize common presenting signs and symptoms of Early Localized, Early Disseminated, and Late Lyme disease from a patient history and physical examinationDetermine whether a patient meets clinical diagnostic criteria and, if not, which lab tests are appropriate for diagnosis of Lyme diseaseAppropriately prescribe the correct antibiotic choice and duration for patients, depending on variation of Lyme disease and accompanying symptomsAccurately and effectively instruct patients in prevention strategies for tick bites and Lyme disease

    Special thanks to Dr. Ingrid Camelo, Dr. Rebecca Yang and Dr. Jacob Eichenberger who peer reviewed today’s episode.

    FREE CME Credit (requires free sign-up): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=11411

    References:

    Rodino KG, Theel ES, Pritt BS. Tick-Borne Diseases in the United States. Clin Chem. 2020 Apr 1;66(4):537-548. doi: 10.1093/clinchem/hvaa040. PMID: 32232463.Lantos PM, Rumbaugh J, Bockenstedt LK, Falck-Ytter YT, Aguero-Rosenfeld ME, Auwaerter PG, Baldwin K, Bannuru RR, Belani KK, Bowie WR, Branda JA, Clifford DB, DiMario FJ, Halperin JJ, Krause PJ, Lavergne V, Liang MH, Meissner HC, Nigrovic LE, Nocton JJJ, Osani MC, Pruitt AA, Rips J, Rosenfeld LE, Savoy ML, Sood SK, Steere AC, Strle F, Sundel R, Tsao J, Vaysbrot EE, Wormser GP, Zemel LS. Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease. Clin Infect Dis. 2021 Jan 23;72(1):e1-e48. doi: 10.1093/cid/ciaa1215. PMID: 33417672.Eddens T, Kaplan DJ, Anderson AJM, Nowalk AJ, Campfield BT. Insights From the Geographic Spread of the Lyme Disease Epidemic. Clin Infect Dis. 2019 Jan 18;68(3):426-434. doi: 10.1093/cid/ciy510. PMID: 29920580; PMCID: PMC6336907.Sundheim KM, Levas MN, Balamuth F, Thompson AD, Neville DN, Garro AC, Kharbanda AB, Monuteaux MC, Nigrovic LE. Seasonality of Acute Lyme Disease in Children. Trop Med Infect Dis. 2021 Nov 9;6(4):196. doi: 10.3390/tropicalmed6040196. PMID: 34842846; PMCID: PMC8628899.2021. "Lyme Disease (Lyme Borreliosis, Borrelia burgdorferi sensu lato Infection)", Red Book: 2021–2024 Report of the Committee on Infectious Diseases, Committee on Infectious Diseases, American Academy of Pediatrics, David W. Kimberlin, MD, FAAP, Elizabeth D. Barnett, MD, FAAP, Ruth Lynfield, MD, FAAP, Mark H. Sawyer, MD, FAAPBax CE, Clark AK, Oboite M, Treat JR. A case of disseminated Lyme disease in a child with skin of color. Pediatr Dermatol. 2021 Nov;38 Suppl 2:140-141. doi: 10.1111/pde.14770. Epub 2021 Sep 13. PMID: 34515362.Lipsett SC, Nigrovic LE. Diagnosis of Lyme disease in the pediatric acute care setting. Curr Opin Pediatr. 2016 Jun;28(3):287-93. doi: 10.1097/MOP.0000000000000339. PMID: 27138805.Shapiro ED. Borrelia burgdorferi (Lyme disease). Pediatr Rev. 2014 Dec;35(12):500-9. doi: 10.1542/pir.35-12-500. PMID: 25452659; PMCID: PMC5029759.Meissner HC, Steere AC. Management of Pediatric Lyme Disease: Updates From 2020 Lyme Guidelines. Pediatrics. 2022 Mar 1;149(3):e2021054980. doi: 10.1542/peds.2021-054980. PMID: 35229121.Bolourchi M, Silver ES, Liberman L. Advanced Heart Block in Children with Lyme Disease. Pediatr Cardiol. 2019 Mar;40(3):513-517. doi: 10.1007/s00246-018-2003-8. Epub 2018 Oct 31. PMID: 30377753.Chason ME, Monaghan M, Wang J, Cheng Y, DeBiasi RL. Symptom Resolution in Pediatric Patients With Lyme Disease. J Pediatric Infect Dis Soc. 2019 May 11;8(2):170-173. doi: 10.1093/jpids/piy067. PMID: 30060012.2021. "Prevention of Mosquitoborne and Tickborne Infection", Red Book: 2021–2024 Report of the Committee on Infectious Diseases, Committee on Infectious Diseases, American Academy of Pediatrics, David W. Kimberlin, MD, FAAP, Elizabeth D. Barnett, MD, FAAP, Ruth Lynfield, MD, FAAP, Mark H. Sawyer, MD, FAAPCenters for Disease Control and Prevention. Preventing Tick Bites on People [Internet]. Atlanta, GA: Centers for Disease Control and Prevention; Sept 2019 [cited 2022 March 30]. Available from: https://www.cdc.gov/lyme/prev/on_people.html
  • Why Colds Are Uncool for Anesthesia

    Why Colds Are Uncool for Anesthesia

    · The MCG Pediatric Podcast

    Did you know that a mild respiratory infection could be the culprit of an adverse respiratory event during a patient undergoing anesthesia? Dr. Pedro Solorzano and Dr. Ana Mavarez join Krishna Shah to discuss the evaluation and management of upper respiratory infections for patients undergoing anesthetic care. Specifically, they will:

    Recall key aspects of the preoperative assessment performed by the pediatric anesthesiologist prior to perform an anesthetic.  Understand why an upper respiratory infection (URI) affects the pediatric anesthesiologist’s decision to proceed or postpone a surgery or procedure requiring anesthesia or sedation.  Identify the severity of the URI symptoms that would increase the likelihood of perioperative respiratory adverse events (PRAE).  Understand the anesthetic management of a patient with an URI to minimize the risk of PRAE requiring emergent anesthesia and the timing to postpone it if the surgery is elective. Initiate interventions to optimize the pediatric patient’s respiratory status with URI prior to receiving anesthesia. 

    FREE CME Credit (requires free sign-up): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=11410

    References:

    Davis, Peter J. and Cladis, Franklyn, "Smith's Anesthesia for Infants and Children. 9th ed. (2017). Chapter 45. Respiratory disorders. Page 1127-1128.Von Ungern-Sternberg BS, Boda K, Chambers NA, Rebmann C, Johnson C, Sly PD, Habre W. Risk assessment for respiratory complications in paediatric anaesthesia: a prospective cohort study. Lancet. 2010 Sep 4;376(9743):773-83. doi: 10.1016/S0140-6736(10)61193-2. PMID: 20816545.Regli A, Becke K, von Ungern-Sternberg BS. An update on the perioperative management of children with upper respiratory tract infections. Curr Opin Anaesthesiol. 2017 Jun;30(3):362-367. doi: 10.1097/ACO.0000000000000460. PMID: 28291127.Cote C, Lerman J amd Anderson B, A Practice of Anesthesia for Infants and Children. 6th ed. (2019). Chapter 13. Essentials of pulmonology. Page 285-286.Houck, P. Anesthesia for the child with a recent upper respiratory infection. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA
  • Näytä enemmän